More than 10,000 Children Involved in School Bus Crashes Annually in Ohio

New findings underscore importance of lap-shoulder belts on school buses as federal government agency prepares to reconsider issue on July 11

Each year in the United States, 25.5 million children travel an estimated 4.3 billion miles on school buses. New research findings by investigators in the Center for Injury Research and Policy (CIRP) at Columbus Children’s Hospital emphasize the large number of children involved in school bus crashes each year. According to the new study, there were approximately 20,800 children younger than age 18 years, who were occupants on a school bus involved in a crash in Ohio during the two-year period, 2003-04.

“This high frequency of children involved in school bus crashes – more than 10,000 per year in Ohio alone – reinforces the need to provide the best occupant crash protection possible to children on school buses, which is a lap-shoulder belt for most school age children,” said Gary Smith, MD, DrPH, director of CIRP at Children’s Hospital and a faculty member of Ohio State University College of Medicine.

In November 2006, this research group was also the first to use a national sample to describe nonfatal school bus-related injuries to children and teenagers treated in hospital emergency departments across the country. Following the release of that study and a number of tragic school bus-related crashes earlier this year, the National Highway Traffic Safety Administration (NHTSA) is holding a public meeting on July 11, 2007, to discuss the issue of seat belts on large school buses.

The previous study from CIRP, published in the November 2006 issue of Pediatrics, found that from 2001 through 2003 there were an estimated 51,100 school bus-related injuries nationally that resulted in treatment in U.S. emergency departments. That equals approximately 17,000 injuries annually. In addition, that study showed that traffic-related crashes are the leading mechanism of nonfatal school bus-related injury to children in the U.S., accounting for 42 percent of injuries.

Current federal regulations use a strategy known as “compartmentalization” as the main method for protecting children in crashes on large school buses. Compartmentalization uses tall padded seat backs on closely spaced seats to provide protection in a crash. However, in the new study examining school bus crashes in Ohio, 23 percent of the children were involved in a side-impact or rollover crash, when compartmentalization offers no protection to child passengers. Compartmentalization also fails to prevent injury from sudden swerves and when children are out of their normal seated position. Lap-shoulder belts keep children in their seats and offer protection during swerves and crashes of all types. In addition, lap-shoulder belts can improve student behavior by keeping children in their seats, which results in less driver distraction and thereby lessens the chance of a crash.

“Compartmentalization may have been the best that could be offered 30 years ago, but this concept is no longer state-of-the-art,” said Dr. Smith. “School bus crash tests show that lap-shoulder belts offer better protection to occupants. Congress stated in 1974 in the School Bus Safety Amendments that school transportation should be held to the highest level of safety because it involves protection of children. If the National Highway Traffic Safety Administration holds to that important mandate as it deliberates this topic this week in Washington, then the decision is clear – lap-shoulder seatbelts should be required on all newly manufactured school buses.”

Findings of the new study were based on data from the Ohio Crash Outcome Data Evaluation System (CODES) program, which links large statewide data bases, including crash and hospital data files for Ohio. The analysis included all children younger than 18 years, who were occupants on a school bus involved in a crash in Ohio, 2003-04. Thirty-nine percent of children were 5-11-years-old (elementary school age), 27 percent were 12-13-years-old (middle school age), and 33 percent were 14-17-years-old (high school age). Most children had minor or no injuries, however, injuries did include two skull fractures, one bleed inside the head, one broken back bone, one serious injury to the spleen, and 28 other head injuries, including concussions. Average hospital charges for those who sought medical care were $730, with a maximum of $68,100.

The Center for Injury Research and Policy (CIRP) works at the local, state, regional, national, and international levels to reduce death and disability due to injuries through research, education, advocacy and advances in clinical care. CIRP aims to improve the scientific understanding of the epidemiology, prevention, acute treatment, rehabilitation, and biomechanics of injuries. CIRP educates health and other professionals, policy makers, and the public regarding the importance of injuries, injury research and injury prevention. CIRP provides leadership in the development, implementation, and scientific evaluation of public policy regarding control of injuries. CIRP provides leadership and technical assistance in injury research and prevention science.